
		<div class="panel panel-default">
		  <div class="panel-heading">
			<h3 class="panel-title">Company Overview</h3>
		  </div>
		  <div class="panel-body">
			
		
			
				<div class="input-group">
				<span class="input-group-addon">Company Name:</span>
				   <input type="text" name='compname' class="form-control form-input-over" placeholder="Company Name" />
				</div>
			
				<div class="input-group">
				 <span class="input-group-addon">Company Billing Address:</span> 
				   <textarea class="form-control form-input-over" name='address' placeholder="Company Billing Address"></textarea>
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Services ordered By:</span>
				   <input type="text" name='services_offered' class="form-control form-input-over" placeholder="Enter your name" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Main Contact #:</span>
				   <input type="text" name='main_contact' class="form-control form-input-over" placeholder="Contact Number" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Company Website:</span>
				   <input type="text" name='compweb' class="form-control form-input-over" placeholder="Website URL" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Select Your icon</span>
				   <input type="text" name='icon' class="form-control icon-picker" placeholder="Select your icon" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Would you like a custom Icon created for your company?</span>
				   <input type="text" class="form-control form-input-over" value='N' />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Choose Basic or Full Service:</span>
				   <input type="text" name='choices' class="form-control form-input-over" placeholder="Choice" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Company Full Description:</span>
				   <textarea name='compdesc'  class="form-control form-input-over" placeholder="For FULL service please prepare & attach a 1 page company overview"></textarea>
				</div>
				
				

		  </div>
		</div>
		
		
		<div id='compinfo' class="panel panel-default">
		  <div class="panel-heading">
			<h3 class="panel-title">Company Location Information</h3>
		  </div>
		  <div class="panel-body">
			
		
			
				<div class="input-group">
				   <span class="input-group-addon">Location # 1:</span><input type="text" name='location1' class="form-control form-input-reg" placeholder="Location" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Company Office Name:</span><input type="text" name='office_name' class="form-control form-input-reg" placeholder="Company Office Name" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Company Location:</span><input type="text" name='company_location' class="form-control form-input-reg" placeholder="Company Location" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Company Location  Website:</span><input type="text" name='complocationweb' class="form-control form-input-reg" placeholder="Company Location  Website" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Company Location Main Contact:</span><input type="text" name='complocmaincont' class="form-control form-input-reg" placeholder="Company Location Main Contact" />
				</div>
			

		  </div>
		</div>
		
		<div id='compserve' class="panel panel-default">
		  <div class="panel-heading">
			<h3 class="panel-title">COMPANY SERVICES</h3>
		  </div>
		  <div class="panel-body">
			
		
			
				<div class="input-group">
				   <span class="input-group-addon">Office Service Categories:</span><input type="text" name='officeservices' class="form-control form-input-reg" placeholder="Office Service Categories" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Category 1:</span><input type="text" name='categories' class="form-control form-input-reg" placeholder="Category 1" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Sales Contact  Email address:</span><input type="text" name='sales_contact_email' class="form-control form-input-reg" placeholder="Sales Contact  Email address" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Sales Contact Phone #1:</span><input type="text" name='sales_contact_phone1' class="form-control form-input-reg" placeholder="Location" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Sales Contact Phone #2:</span><input type="text" name='sales_contact_phone2' class="form-control form-input-reg" placeholder="Location" />
				</div>
				
				<div class="input-group">
				   <span class="input-group-addon">Add another Office?:</span><input type="text"  class="form-control form-input-reg" placeholder="Location" />
				</div>
			

		  </div>
		</div>
		